An alarming rise in methamphetamine (meth) use among Native American communities, fueled in large part by Mexican drug cartels, has led to increased drug treatment and prevention efforts. A Bureau of Indian Affairs study called meth the drug that currently poses the greatest threat to the Indian community.

In 2006, at Health and Human Services Tribal Round Table sessions and at other tribal gatherings throughout the country, meth abuse was identified as the primary health concern for Indians. The National Congress of American Indians (NCAI) took the lead in further addressing the meth crisis by forming a National Indian Country Tribal Meth Initiative Task Force.

In addition to creating an educational Indian Country Meth Toolkit, the Task Force partnered with the Office of National Drug Control Policy, U.S. Health and Human Services, the Bureau of Indian Affairs, and the Partnership for a Drug-Free America to launch the first ever anti-meth public service campaign targeted toward American Indian and Native Alaskan populations.

The radio and print ads are available for free as a public service at www.ncai.org/meth/ or www.MethResources.gov. Separate ads were developed for youth and adults because research revealed youth wanted to hear a positive message about alternatives to meth and adults wanted guidance and recommendations for parents and those who deal with children.

Ideally, awareness of a problem leads to action. As has been true with alcohol intervention and prevention in Native American communities, inclusive programs that incorporate the customs, values and traditions of a tribe also work well when it comes to meth intervention, treatment and prevention. Discovering what works got easier for Native communities with the creation of One Sky Center (www.oneskycenter.org).

Initially funded by the Substance Abuse and Mental Health Services Administration, One Sky Center was established in 2003 as the first national resource center to serve Indians from all U.S. tribes and urban communities. It began as a repository of successful and culturally appropriate Native American prevention and treatment programs and has grown to also provide training, technical assistance, and products for treatment practitioners who serve this population.

"Before we undertook this effort, people were reinventing the wheel a lot," said Dr. R. Dale Walker, a member of the Cherokee tribe and director of One Sky Center. "There are some incredibly novel programs, and I hope we've had some impact on getting information out to Native American communities. Once a community contacts us, we're partners forever to provide education and best practices."

One Sky Center catalogs various programs so members of tribes can see what others have done and how they might adapt the program to fit their own needs and traditions. For instance, a number of tribes hold Meth Walks or Meth Rides, where children walk or ride horseback, chanting "no more meth." In Lodge Grass, Mont., students participate in walks against meth and then listen to messages from community and spiritual leaders.

The Lummi Nation of Washington and Yavapai-Apache Nation in Arizona use the sovereign tribal right of banishment to keep meth dealers out of their communities. On the Rocky Boy Indian Reservation in Montana, tribal courts "sentence" youth offenders to time before their elders in lieu of incarceration. The elders assign the youth different cultural endeavors and lessons, enlisting the parents for follow-through on the assignments. The Choctaw Nation of Oklahoma has created a "Natural Highs" adventure therapy prevention program that involves horses, canoes and tradition camps to build self-esteem and healthy relationships.

Walker said the evidence-based "Matrix Model" (Hazelden, 2005) that incorporates motivational interviewing and a collection of treatment approaches for alcohol and other drug problems has been shown to be effective for the treatment of meth addiction. "I am a real optimist about the teaching of therapies for alcohol and drug counselors who work with patients in Indian country," said Walker.

In addition to initial training, however, he said the opportunity for life-long learning is important. It is his hope that well-recognized training skills will eventually extend to all Native American communities and that subsequent training will become available electronically for those in remote areas. "How do alcohol and drug counselors in isolated areas maintain their credentials?" Walker asks. "We have to do better if we want to make treatment effective throughout the United States."

--Published August 4, 2008